Barbara A Mansholt
Chiropractic & Manual Therapies 2013, 21:33
Evidence-based clinical practice (EBCP) is an accepted practice for informed clinical decision making in mainstream health care professions. EBCP augments clinical experience and can have far reaching effects in education, policy, reimbursement and clinical management. The proliferation of published research can be overwhelming—finding a mechanism to identify literature that is essential for practitioners and students is desirable. The purpose of this study was to survey leaders in the chiropractic profession on their opinions of essential literature for doctors of chiropractic, faculty, and students to read or reference.
Articles with multiple recommendations
Six distinct articles were recommended by more than one respondent. Six respondents recommended the article,“Effectiveness of manual therapies: the UK evidence report”, by Bronfort et al.. A majority of the respondents noted the comprehensive nature of this systematic review of randomized clinical trials of spinal manipulation, mobilization and massage. This article addresses varying levels of evidence and cites 322 articles on spinal manipulation and other manual therapies as treatments for musculoskeletal, headache and non-musculoskeletal conditions in an organized and easily readable manner. One respondent wrote, “This is the most comprehensive systematic review of the literature pertinent to DCs for both musculoskeletal (MSK) and non-MSK conditions”.
Two respondents each recommended five additional studies. An article published in 2002 by Pickar, “Neurophysiological effects of spinal manipulation”, is one of the earliest publications making the list, confirming the author’s early attention to identifying the basic mechanisms of action underlying spinal manipulation and the relevance of the topic for doctors of chiropractic. One respondent wrote, “[the article] provides evidence based scientific rationale for the effects of spinal manipulation”.
Another basic science article, this one by Ianuzzi and Khalsa, “Comparison of human lumbar facet joint capsule strains during simulated high-velocity, low-amplitude spinal manipulation versus physiological motions,” was similarly recommended by respondents: “an important paper for mechanisms of action of spinal manipulation” and “demonstrated intrinsic biomechanical safety of lumbar spinal manipulation”.
The large population-based study by Cassidy et al. “Risk of vertebrobasilar stroke and chiropractic care: results of a population-based case–control and case-crossover study”, demonstrated vertebrobasilar stroke as a very rare adverse event. This article is a relevant reference for chiropractic professionals who educate their patients, other healthcare providers and the media about the risks of chiropractic care. One respondent commented, “This presents the best evidence about the risk of stroke after cervical manipulation”.
A Cochrane Collaboration systematic review published by Walker and colleagues, “Combined chiropractic interventions for low back pain”, represented a rigorous, international, and interdisciplinary evaluation of the merits combined chiropractic therapies over spinal manipulation alone for pain and disability. Of this article, one respondent wrote, “This systematic review shows that usual chiropractic care is as effective as many other therapies for acute or sub acute low back pain”.
An article by Murphy et al., “The establishment of a primary spine care practitioner and its benefits to health care reform in the United States,” presented a cogent health policy rationale for changing the role of chiropractors in the U.S. health care delivery system based on research evidence. Individuals interested in the evolution of the chiropractic profession should be familiar with this document, as a respondent commented, “This article outlines the need for a primary spine care clinician in the health care system, and highlights the qualifications of DCs to fill this niche”.
Full Text Article: http://www.chiromt.com/content/21/1/33